Experience with recipient splenic artery inflow in adult liver transplantation: a case series

INTRODUCTION: Hepatic artery thrombosis following orthotopic liver transplant is one of the most common reasons for early graft failure. Meticulous reconstitution of hepatic artery flow remains essential for good outcomes. Prior surgery, body habitus, hepatic artery inadequacy and anatomic differences can complicate hepatic artery revascularization. CASE PRESENTATION: We report a single institution's experience, from January 1996 to January 2007, using splenic artery inflow in seven patients with inadequate native hepatic arteries. CONCLUSION: End-to-side anastomosis was associated with postanastomotic intimal hyperplasia. End-to-end anastomosis provided effective hepatic inflow, demonstrated splenic and pancreatic safety, and was not associated with the intimal hyperplasia experienced with end-to-side anastomosis.